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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: This amendment allows the West Virginia Bureau of Medical Services to provide payments to private or public, non-state government hospitals on behalf of Medicaid individuals with a substance use disorder who are awaiting placement effective June 1, 2022.
Summary: The purpose of this SPA is Oklahoma’s Annual Rebasing of Rates for regular nursing facilities, nursing facilities serving residents with Acquired Immune Deficiency Syndrome (AIDS), and acute and regular Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IIDs).
Increases rates for Out Patient Behavioral Health Agency Services, Residential Level of Care Substance Abuse Disorder Services and Independently Contracted Psychologists.
Summary: Chronic Conditions Health Home - Managed Care Implementation to reflect the change in the Chronic Condition Health Home Informational Only Code for Comprehensive Transitional Care from G2065 to 99429. There were no other programmatic or reimbursement methodology changes observed.
Summary: Health Home - Managed Care Implementation to reflect the change in the Integrated Health Home (IHH) Informational Only Code for Comprehensive Transitional Care from G2065 to 99429. This SPA also increases the IHH PMPM reimbursement rate for Pediatric Non-ICM enrollees (99490 TG) from $121.14 to $200.97.
Summary: This Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) plan amendment implements an updated Medicaid Youth Mental Health Fee Schedule, reflecting updated reimbursement rates.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to provide bonus payments to providers of personal care services and targeted case management to address the COVID-19 PHE and in accordance with the State’s approved Home and Community Based Services spending plan authorized under Section 9817 of the American Rescue Plan Act.